Every home in the U.S. is eligible to order 4 free at home COVID-19 tests. Orders usually ship in 7-12 days. Click here to order your free at home tests.
Beginning January 15, 2022, the Plan is required to cover FDA approved at home COVID-19 tests with no cost-sharing*.
The Biden administration released guidance mandating group health care plans and insurers to provide coverage of Over The Counter, FDA approved at home COVID-19 tests. According to this guidance, FDA approved at home COVID-19 tests are to be covered with no member cost-share effective January 15, 2022. At home tests obtained prior to January 15, 2022 are not subject for reimbursement under this mandate.
*If obtained at an out-of-network pharmacy, reimbursement is the actual price paid or $12 per test, whichever is less.
Here is what you need to know:
- This is applicable to all eligible active members, their covered dependent(s) & non-Medicare eligible retirees and their covered dependent(s)
- This is not applicable to Medicare- eligible retirees with coverage under the RWP Medicare PDP or any other Medicare Part D Prescription Drug Program
- There is no coverage under Medical for the FDA approved at home COVID-19 tests as outlined under this mandate
- This mandate does not include employer mandated tests for employment purposes
- There is a quantity limit of 8 tests, per covered member/dependent(s), per Calendar Month
- There is no cost-sharing for the member
- The cost of the at home test does not apply to the member’s deductible or out-of-pocket costs
- You do not need a prescription to obtain an at home test
- The current list of FDA approved at home tests include Flowflex™, Ellume™, InteliSwab™, BinaxNOW™ and On/Go™
- There is absolutely no reimbursement allowed under the Family Supplemental Benefit.
Below are two options to obtain an FDA approved at home COVID-19 test. Please choose whichever one is applicable to you:
Obtain through a network pharmacy:
- You can obtain an at home test by presenting your MOE Vendor Card to the Pharmacy at a network location
- Currently, the network consists of Walgreens, Walmart Pharmacy, Sam’s Club, Rite Aid & Kinney Drugs. Please note that the general Prescription Drug Program network has not changed. The pharmacy network listed is only applicable to obtaining an FDA approved at home COVID-19 test.
- When you utilize the Prescription Drug Program by presenting your MOE Vendor Card at the pharmacy counter, there will be no out of pocket cost to you
Direct Member Reimbursement (DMR):
- If you are unable to utilize a Walgreens, Walmart Pharmacy, Sam’s Club, Rite Aid or Kinney Drugs, you can purchase an at home kit at an out-of-network pharmacy and submit your receipts for reimbursement through OptumRx
- For this option you would pay out of pocket for your test and submit a reimbursement request. Per current guidance, reimbursement is the actual price paid or $12 per test, whichever is less.
- You have two options for submitting your reimbursement request:
- You can input your information electronically here. You must upload your original register receipt for your request to be submitted.
- Unfortunately, we are unable to give a turnaround time for receiving your reimbursement.
- To request your reimbursement manually, you can complete the DMR form (DMR form linked here)
- You must include your original receipt with your completed form and mail them to:
- OptumRx Claims Department, PO Box 650334, Dallas, TX 75265-0334
- Reimbursements must be sent to the OptumRx address above. Please do not send them to the Fund Office, they will be returned to you.
- You will receive your reimbursement through the mail. Unfortunately, we are unable to give a turnaround time for receiving your reimbursement.
If you have any questions, please refer to the OptumRx FAQ’s or you can contact the Pharmacy Benefit Department at 708-387-8331.